Provider Demographics
NPI:1437235264
Name:KIMBERTON DENTAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:KIMBERTON DENTAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NHAT-KHAI
Authorized Official - Middle Name:NGUYEN
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-935-0525
Mailing Address - Street 1:603 VILLAGE AT ELAND
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-2273
Mailing Address - Country:US
Mailing Address - Phone:610-935-0525
Mailing Address - Fax:610-983-3962
Practice Address - Street 1:603 VILLAGE AT ELAND
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-2273
Practice Address - Country:US
Practice Address - Phone:610-935-0525
Practice Address - Fax:610-983-3962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0358391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty